Background The Nursing Home Survey on Patient Safety Culture (NHSOPS) questionnaire was developed by the Agency for Healthcare Research and Quality (AHRQ), particularly as an intervention to raise staff awareness about patient safety issues. The main objective of the present study was to provide a validated French-language measure of the safety culture (SC) in nursing homes. Thus the aim was i) to carry out a transcultural adaptation into French of the NHSOPS questionnaire, ii) to assess its psychometric properties in a sample of professionals working in French EHPAD facilities and iii) to develop our own tool. Methods The study was carried out on volunteering professionals from 61 nursing homes (from January to March 2016). Two phases were conducted: an initial phase involving the translation and cultural adaptation of the questionnaire, and a second phase in which the psychometric properties of the questionnaire were assessed. A Structural Equation Model (SEM) with a maximum likelihood estimation method was used to evaluate the construct validity of the questionnaire. As the fit of the structure was not sufficient, an exploratory factor analysis using a principal axis factoring with an oblique rotation was then performed. Internal consistency was evaluated and we examined test-retest reliability using Intra-class Correlation Coefficients (ICC). Results During the initial phase, all items were retained and minor adjustments were made. The participation rate by professionals was 58.4%. The exploratory analysis led to the identification of seven dimensions: Teamwork, Staffing, Compliance with procedures, Handoffs, Feedback and communication about incidents, Supervisor expectations and actions promoting resident safety, Overall perceptions of resident safety and Organizational learning. The SEM confirmed the existence of the seven latent dimensions (CFI = 0.946; TLI = 0.933; SRMR = 0.059; RMSEA = 0.061); internal consistency was acceptable. ICC per item ranged from 0.19 to 0.88. Conclusions The results from this study were robust on seven dimensions. This French version is the first on Patient SC to have been applied to the medical-social sector caring for dependent elderly people in France. The NHSOPS questionnaire provides the opportunity to broach this subject. A national evaluation campaign should provide the opportunity to confirm or improve this measure. Trial registration NCT02908373 (September 21, 2016) «Retrospectively registered». Electronic supplementary material The online version of this article (10.1186/s12913-019-4333-5) contains supplementary material, which is available to authorized users.

Background In France, hospital units responsible for providing inpatient care have few opportunities to address the issue of task interruptions. In Australia, the Dual Perspectives Method (DMP) has been developed to assess interruptions. The method makes it possible to link teamwork and interruptions, by considering the work functions that constitute the system. Objective To develop a tool that can characterize interruptions from the point of view of work functions that is tailored to French hospital units providing inpatient care. The aim was to adapt the items recorded using the DPM and their response categories, and to study the acceptability of observing interruptions for participating teams. Method The items recorded in the DPM were translated and adapted taking into account the French definition of interruptions. This step identified 19 items that targeted the interrupted professional, and 16 that targeted the interrupting professional. The characteristics of interruptions were recorded in September 2019 among 23 volunteer teams in a region in western France. Two observers simultaneously observed the same professional. Observations lasted seven consecutive hours, and targeted all professional categories within the same team. Results The characteristics of 1,929 interruptions were noted. The observation period was well-received by teams. The following terminology regarding the work functions of the interrupting professional was clarified: “coordination of institutional resources”, in relation to “the establishment’s support processes”, “patient services”, and “the patient’s social life”. We believe that our categorization of response modes is exhaustive. Conclusions We have developed an observational tool, Team’IT, which is tailored to inpatient hospital care in France. Its implementation is the first step in a system to support teams in managing interruptions, and will enable them to reflect on their working methods, and whether interruptions can be avoided. Our work is part of an approach that seeks to improve and enhance the safety of professional practices, by contributing to the longstanding, complex debate about the flow and effectiveness of patient care. Trial registration ClinicalTrials.gov NCT03786874 (December 26, 2018).

Background French nursing homes (NHs) are in the early stages of implementing their risk management approach. The latter includes the development of a safety culture (SC) among professionals. A training package to support NHs in implementing a risk management strategy has been designed by QualiREL Santé, a regional body that provides support in quality and risk management. The aim is to improve SC. No data are available about the level of SC in French NHs. This study evaluates the level of SC and identifies predictors of SC scores in NHs that will subsequently benefit from the training package. Method The study was proposed to NHs who are members of QualiREL Santé in 2 French departments. Inclusion criteria were voluntary participation, the commitment of top management to benefit from the training package, and the absence of previous risk management support provided by QualiREL Santé. The NHSOPS-F questionnaire (22 items measuring 7 dimensions of SC) was administered to professionals between January and March 2016. 14 variables related to the structural profile of the NHs and the strategic choices of top management in terms of healthcare safety were recorded. Scores for 7 dimensions were calculated for all of the included NHs. Further modelling identified predictive factors. Results 58 NHs were included. The response rate for the NHSOPS-F (n = 1946 professionals) was 64% (Q1-Q3 = [49.4;79.0]). Staffing was the least-developed dimension (11.8%), while scores were highest for Feedback and communication about incidents (84.8%). Being attached to a public hospital was associated with poorer perceptions of SC, notably for the dimension “Overall perceptions of resident safety and organizational learning” (β = − 19.59;p-value< 0.001). A less-developed SC was also significantly linked to existing Quality initiatives. Conclusions Overall, French NHs must prioritise issues of staffing, teamwork and compliance with procedures. The role of human factors within teams should be exploited by top management. Our initial findings will help to adapt improvement approaches and are particularly relevant to local and national policies during the ongoing pandemic.

Background French Nursing Homes (NHs) are in the early stages of implementing their Risk Management (RM) approach. A regional structure, which was mandated to provide independent support in RM, designed a training package. Objective To study the impact of the RM training package on safety culture (SC) in NHs and drivers for improvement in SC scores. Method and analysis This randomised controlled study targeted French NHs. Inclusion criteria were voluntary participation, no external support provided on the topic of adverse incidents upstream of the project, and the commitment of top management to its implementation. The 61 NHs were randomly allocated to one of two groups: the first benefited from a training package; support was given to the second after the impact measurement. Seven dimensions of SC were measured, at an 18-month interval, using the validated Nursing Home Survey on Patient Safety Culture questionnaire (22 items), which was administered to all of the professionals working in NHs. Eleven variables were captured, relating to the structural profile of the NH, the choices of top management in terms of healthcare safety, and the implementation of the system. Further modelling identified predictive factors for changes in SC scores. Results 95% of NHs completed both rounds of the questionnaire. The dimension Feedback and communication about incidents (SC = 85.4% before the intervention) significantly improved (+2.8%; p = 0.044). Improvement in the dimension Overall perceptions of resident safety–organizational learning was close to significant (+3.1%; p = 0.075). Drivers for improvement in scores were a pre-existing quality improvement approach, and a steering group that showed RM leadership. Conclusions The system appears to have improved several dimensions of SC. Our findings are all the more important given the current crisis in the healthcare sector. Trial registration Retrospectively registered as NCT02908373 (September 21, 2016).